Accuracy of Self-Reported Health Care Use in a Population-Based Sample of Homeless Adults.

OBJECTIVE: To assess the accuracy of self-reported ambulatory care visits, emergency department (ED) encounters, and overnight hospitalizations in a population-based sample of homeless adults. DATA SOURCE: Self-report survey data and administrative health care utilization databases. STUDY
DESIGN: Self-reported health care use in the past 12 months was compared to administrative encounter records among 1,163 homeless adults recruited in 2004-2005 from shelters and meal programs in Toronto, Ontario. DATA EXTRACTION
METHODS: Self-reported health care use was assessed using a structured face-to-face survey. Each participant was linked to administrative databases using a unique personal health number or their first name, last name, sex, and date of birth. PRINCIPAL
FINDINGS: The sensitivity of self-report for ambulatory care visits, ED encounters, and overnight hospitalizations was 89, 80, and 73 percent, respectively; specificity was 37, 83, and 91 percent. The mean difference between self-reported and documented number of encounters in the past 12 months was +1.6 for ambulatory care visits (95 percent CI = 0.4, 2.8), -0.6 for ED encounters (95 percent CI = -0.8, -0.4), and 0.0 for hospitalizations (95 percent CI = 0.0, 0.1).
CONCLUSIONS: Adults experiencing homelessness are quite accurate reporters of their use of health care, especially for ED encounters and hospitalizations. © Health Research and Educational Trust.